Method and System for Generating a Dental Implant Surgical Drill Guide

ABSTRACT

A method and system for producing a dental implant surgical guide is disclosed. A patient-specific virtual model is generated using image data specific to a patient and virtual dental implants. The virtual model aligns the image data with the virtual dental implants using modeling software. A virtual mold is generated from the virtual model, and a physical mold is generated from the virtual mold. The physical mold is covered with a thermoplastic sheet via a thermoforming process. Excess thermoplastic material is trimmed off after the thermoforming process to produce a thermoformed piece. Metal tubes corresponding to each the virtual dental implants are placed onto the physical mold denoting the position, trajectory, and depth of the one or more virtual dental implants. A dental implant surgical guide that contains the thermoformed piece with the one or more tubes is produced.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/311,466 filed on Dec. 5, 2011, entitled “METHOD AND SYSTEM FORGENERATING A DENTAL IMPLANT SURGICAL DRILL GUIDE,” which is incorporatedby reference in its entirety.

FIELD

The field of the invention relates generally to dental implant surgicalguide, and more particularly to method and system for generating adental implant surgical drill guide.

BACKGROUND

Recent technological developments in image acquisition, image planningsoftware for dental implants, and software-based modeling allowed for arapid, accurate, and controlled surgical planning and more accuratesurgical placement of dental implants. Surgical guides, made to theshape and contour of a patient's anatomy, are used to precisely guidedrilling a hole following the CT image plan's predetermined position,angle, and/or depth into a patient's jawbone. The finished hole is usedfor screwing in a dental implant. Such surgical planning and accuratesurgical placement minimizes the patient's discomfort, reduces time forthe surgical procedure, and patient's healing.

When drilling for a dental implant into the patient's jawbone, multipledrilling bits of different diameters are used in sequence to enlarge andobtain a hole with a desired size, shape, and depth. A series ofdrilling procedures requires meticulous planning and execution tominimize the patient's discomfort while ensuring accurate placement ofthe hole and avoiding vital structures such as the sinus cavity,inferior alveolar nerve and the mental foramen within the mandible. Tofacilitate the drilling procedures, a surgical guide maintains theposition, angle, and/or depth of drilling bits while drilling. In eachprocedure, a slightly larger drill bit is used until the desired shape,diameter and depth of the hole is achieved.

SUMMARY

A method and system for producing a dental implant surgical guide isdisclosed. A patient-specific virtual model is generated using imagedata specific to a patient and virtual dental implants. The virtualmodel aligns the image data with the virtual dental implants usingmodeling software. A virtual mold is generated from the virtual model,and a physical mold is generated from the virtual mold. The physicalmold is covered with a thermoplastic sheet via a thermoforming process.Excess thermoplastic material is trimmed off after the thermoformingprocess to produce a thermoformed piece. Metal tubes corresponding toeach the virtual dental implants are placed onto the physical molddenoting the position, trajectory, and depth of the one or more virtualdental implants. A dental implant surgical guide that contains thethermoformed piece with the one or more tubes is produced.

The above and other preferred features, including various novel detailsof implementation and combination of elements, will now be moreparticularly described with reference to the accompanying drawings andpointed out in the claims. It will be understood that the particularmethods and apparatuses are shown by way of illustration only and not aslimitations. As will be understood by those skilled in the art, theprinciples and features explained herein may be employed in various andnumerous embodiments.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are included as part of the presentspecification, illustrate the presently preferred embodiment of thepresent invention and together with the general description given aboveand the detailed description of the preferred embodiment given belowserve to explain and teach the principles of the present invention.

FIG. 1 illustrates an exemplary three-dimensional (3D) model, accordingto one embodiment;

FIG. 2A illustrates an exemplary virtual model, according to oneembodiment;

FIG. 2B illustrates an exemplary virtual mold generated from the virtualmodel, according to one embodiment;

FIG. 2C illustrates an exemplary physical mold generated from a virtualmold, according to one embodiment;

FIG. 3A illustrates a cross-section of a virtual model, according to oneembodiment;

FIG. 3B illustrates a cross-section of a physical mold, according to oneembodiment;

FIG. 4A illustrates an exemplary thermoforming system, according to oneembodiment;

FIG. 4B illustrates a rigid state of a thermoplastic sheet;

FIG. 4C illustrates a softened state of a thermoplastic sheet ready forthermoforming;

FIG. 4D illustrates an exemplary process for thermoforming preparation,according to one embodiment

FIG. 4E illustrates an exemplary process for thermoforming, according toone embodiment;

FIG. 5A illustrates a cross-section of a physical mold afterthermoforming application, according to one embodiment;

FIG. 5B illustrates the application of a uniform distributed pressureduring thermoforming application, according to one embodiment;

FIG. 5C illustrates an exemplary cross-section of a physical mold duringthermoforming application after a uniform pressure has been applied;

FIG. 6A illustrates an exemplary thermoformed mold, according to oneembodiment;

FIG. 6B illustrates an exemplary process for trimming a thermoformedthermoplastic sheet, according to one embodiment;

FIG. 7A illustrates an exemplary milling procedure, according to oneembodiment;

FIG. 7B illustrates an exemplary trimmed thermoplastic piece with asocket receptacle flat planar surface, according to one embodiment;

FIG. 7C illustrates an exemplary process for inserting a metal tube intoa socket receptacle, according to one embodiment;

FIG. 7D illustrates a cross-section of a metal tube when inserted intothe socket receptacle, according to one embodiment; and

FIG. 8 illustrates an exemplary finished dental implant surgical guide,according to one embodiment.

It should be noted that the figures are not necessarily drawn to scaleand that elements of structures or functions are generally representedby reference numerals for illustrative purposes throughout the figures.It also should be noted that the figures are only intended to facilitatethe description of the various embodiments described herein. The figuresdo not describe every aspect of the teachings described herein and donot limit the scope of the claims.

DETAILED DESCRIPTION

A method and system for producing a dental implant surgical guide isdisclosed. A patient-specific virtual model is generated using imagedata specific to a patient and virtual dental implants. The virtualmodel aligns the image data with the virtual dental implants usingmodeling software. A virtual mold is generated from the virtual model,and a physical mold is generated from the virtual mold. The physicalmold is covered with a thermoplastic sheet via a thermoforming process.Excess thermoplastic material is trimmed off after the thermoformingprocess to produce a thermoformed piece. Metal tubes corresponding toeach the virtual dental implants are placed onto the physical molddenoting the position, trajectory, and depth of the one or more virtualdental implants. A dental implant surgical guide that contains thethermoformed piece with the one or more tubes is produced.

In the following description, for purposes of clarity and conciseness ofthe description, not all of the numerous components shown in theschematic are described. The numerous components are shown in thedrawings to provide a person of ordinary skill in the art a thoroughenabling disclosure of the present invention. The operation of many ofthe components would be understood to one skilled in the art.

Each of the additional features and teachings disclosed herein can beutilized separately or in conjunction with other features and teachingsto provide the present table game. Representative examples utilizingmany of these additional features and teachings, both separately and incombination, are described in further detail with reference to theattached drawings. This detailed description is merely intended to teacha person of skill in the art further details for practicing preferredaspects of the present teachings and is not intended to limit the scopeof the claims. Therefore, combinations of features disclosed in thefollowing detailed description may not be necessary to practice theteachings in the broadest sense and are instead taught merely todescribe particularly representative examples of the present teachings.

The methods presented herein are not inherently related to anyparticular computer or other apparatus. Various general-purpose systemsmay be used with programs in accordance with the teachings herein, or itmay prove convenient to construct more specialized apparatus to performthe required method steps. The required structure for a variety of thesesystems will appear from the description below. In addition, the presentinvention is not described with reference to any particular programminglanguage. It will be appreciated that a variety of programming languagesmay be used to implement the teachings of the invention as describedherein.

Moreover, the various features of the representative examples and thedependent claims may be combined in ways that are not specifically andexplicitly enumerated in order to provide additional useful embodimentsof the present teachings. In addition, it is expressly noted that allfeatures disclosed in the description and/or the claims are intended tobe disclosed separately and independently from each other for thepurpose of original disclosure, as well as for the purpose ofrestricting the claimed subject matter independent of the compositionsof the features in the embodiments and/or the claims. It is alsoexpressly noted that all value ranges or indications of groups ofentities disclose every possible intermediate value or intermediateentity for the purpose of original disclosure, as well as for thepurpose of restricting the claimed subject matter. It is also expresslynoted that the dimensions and the shapes of the components shown in thefigures are designed to help understand how the present teachings arepracticed but are not intended to limit the dimensions and the shapesshown in the examples.

According to one embodiment, a CT image of the patient's mouth is usedto plan the position and orientation of dental implants in patient'sjawbone. The dental implant planning may be done in a digital realmusing digital image-based planning software. The CT image data (e.g.,DICOM data) is imported into the software to render a three-dimensional(3D) image of the CT image. The surgeon reviews the reconstructed 3D CTimage and positions a virtual dental implant around the area of interestwithin the patient's mouth to determine the actual position andorientation of a dental implant. Other considerations are made duringthe planning procedure taking into consideration of the size of thedental implant, accessibility of the dental implant during theprocedure, vital structures of the patients, etc.

A physical model of the patient's mouth is acquired via traditionaldental lab techniques. The physical model is transitioned to a virtualmodel through various forms of software-based modeling techniques, suchas CT or optical scanning in combination with 3D virtual modelgenerating software. The virtual model is anatomically aligned to thepatient CT medical image within the software. Based on the virtualmodel, a virtual mold that maintains the position and orientation ofsoftware planned dental implants is obtained. Using the virtual mold,the physical mold is generated, for example, via rapid prototypingtechniques. After the physical mold is obtained, a thermoplastic sheetis formed over the physical mold via thermoforming techniques. Excessthermoplastic material is removed through various techniques, such astrimming, cutting, milling, and/or deburring. Metal tubes arepermanently attached in the sockets of the remaining thermoplasticpiece. Those metal tubes are used to guide surgical drills during asurgical procedure. After completing the thermoforming, machining, andmetal tube integration procedures, a patient-specific dental implantsurgical guide is obtained.

FIG. 1 illustrates an exemplary three-dimensional (3D) model of apatient's lower head bone and teeth structure, according to oneembodiment. Using CT image software for dental implant planning, thepatient's CT image is rendered in a 3D space. The 3D model containingthe patient's bone and teeth anatomy 101 is further enhanced with thepatient's marked vital structures such as inferior alveolar nerves 104and mental foramen. Such a 3D model allows for a doctor to virtuallyplan dental implants 102 for safe and optimal positioning andorientation with reduced clinical risk. Anchor pin 103 for the surgicalguide may be selected from the repository of implant objects in thesoftware and included in the 3D model.

FIG. 2A illustrates an exemplary virtual model of patient's mouth,according to one embodiment. Virtual model 201 represents the anatomy ofpatient's mouth and is constructed from the patient's CT medical image.Virtual model 201 is aligned with the patient's virtual dental implants102 and anchor pin 103 in their same position and orientation.

A physical model of the patient can be obtained in various ways.Artifacts and noise contained in the CT image may be removed bypost-processing of the CT data. The enhanced quality CT data may be usedto produce a physical model directly from virtual model 201. However,due to the limited resolution, artifacts and noise from the CT imagewith varying density, and other factors, the modeling software may notprovide enough accuracy to produce a surgical guide that seatsaccurately on virtual model 201. In this case, a physical model isobtained from the patient, for example, by fabricating a traditionaldental model from a dental impression. Various techniques are used toobtain virtual model 201 from the physical model. For example, thephysical model is optically scanned or CT scanned. The modeling softwareuses the scan data of the physical model to generate virtual model 201.High resolution optical scanning may scan patient's mouth and directlygenerate virtual model 201 from the scanned data.

Virtual model 201 is loaded into the modeling software for merging withthe patient's CT medical image. The operator aligns virtual model 201 tothe patient CT medical image by matching the patient's identicalanatomical landmarks such as teeth or gum. During the CT scan, thepatient may wear a removable unit to identify the patient's anatomicallandmarks. The alignment accuracy is dependent on the patient CT medicalimage resolution, clarity, accuracy, the resolution and accuracy ofvirtual model 201, and the skill of the operator. When sufficientalignment accuracy is obtained, the position and orientation of virtualdental implants 102 is transferred from the CT medical image to virtualmodel 201.

FIG. 2B illustrates an exemplary virtual mold generated from the virtualmodel, according to one embodiment. The position and orientation ofvirtual dental implants 102 and anchor pin 103 are maintained byplatform-socket features 203 and 204. Using the modeling software, theoperator modifies the shape of virtual model 201 and creates variousfeatures including virtual mold 202 on the virtual model. In thisexample, these features include platform-socket features 203 and 204that carry important dimensional information from virtual model 201 ontovirtual mold 202.

FIG. 2C illustrates an exemplary physical mold generated from a virtualmold, according to one embodiment. The physical model is outfitted withfeatures 205 and 206 that are seated against platform-socket features203 and 204. In one embodiment, physical mold 202 b is created fromvirtual mold 202 via rapid prototyping. Virtual mold 202 is saved in astandard file format, for example stereolithography (STL) that iscompatible in majority of rapid prototyping systems. Various prototypingtechniques may be used to create physical mold 202 b, for example,selective laser addition (SLA), 3D printing, and 5 dimensional milling.Each prototyping means has its pros and cons in terms of accuracy,surface quality, print efficiency, cost, material properties, etc.

FIG. 3A illustrates a cross-section of a virtual model, according to oneembodiment. FIG. 3B illustrates a cross-section of a physical mold,according to one embodiment. Physical mold 202 b has the platform-socketfeature 203 and part 205 seated against feature 203.

Virtual implant 102 is positioned in its doctor planned position withrespect to virtual model 201. The position and orientation of virtualimplant 102 is transferred to virtual mold 202 via platform-socket 203.In one embodiment, platform sockets 203 are circular and concentricabout a central axis with respect to virtual implant 102 or anchor pin103. In the modeling software, an offset is added from the top toposition platform socket 203 from virtual implant 102. If additionalcomponents such as pin 205 are used in conjunction with theplatform-socket 203, simply adding the offset and the length addedallowing control of the implant depth from a certain offset positionabove virtual implant 102.

Additional features may be added to virtual mold 202. In one embodiment,filled-in negative (undercut) space is added to improve thermoformremoval from virtual mold 202. Physical mold 202 b created from virtualmold 202 is then prepared for thermoforming. In this case, physicalcomponents and pins 205 and 206 are fully placed within platform-sockets203 and 204.

Thermoforming is a process in which a thermoplastic sheet is heated to asoftened state and then pressed onto a mold or die. With sufficient anduniform pressure applied to the non-contact surface of the sheet, thethermoplastic sheet conforms to the outer shape of the mold or die. Thethermoplastic is then cooled to obtain the shape of the mold or die. Theshape of the thermoplastic sheet is maintained as long as it stayswithin a certain temperature range and does not experience significantforces causing physical deformation.

FIG. 4A illustrates an exemplary thermoforming system, according to oneembodiment. Thermoforming system 401 has locking clamp 402, heating unit403, control panel 404, platform 405, pressure chamber 406 and lockingmechanism 407. A thermoplastic sheet is held by locking clamp 402.Heating unit 403 produces heat to raise the temperature and soften thethermoplastic sheet ready for thermoforming. The operator enters inputsto control panel 404 for specifying the heating time, heating power,pressure, and other control parameters for the thermoforming process.Physical mold 202 b is placed upright and centered on platform 405.Thermoforming system 401 utilizes positive pressure to providesufficient and uniform pressure onto the thermoplastic sheet for properforming over physical mold 202 b. When the thermoplastic sheet is placedover physical mold 202 b, locking mechanism 407 locks pressure chamber406 in place and signals for the unit to flood pressure chamber 406 withcompressed air. Pressure chamber 406 is filled with compressed air froman external source to thermoform the thermoplastic sheet.

Thermoplastic is a type of material that loses its rigidity and changesto a softened, easily deformable state when it is exposed to asufficient amount of heat. Thermoplastic properties vary with materialproperties, chemical composition, color, and thickness, etc. For theapplication of a dental implant surgical guide, thermoplastic materialis used that is bio compatible, transparent in color and of sufficientthickness to be rigid when thermoformed.

FIG. 4B illustrates a rigid state of a thermoplastic sheet.Thermoplastic sheet 408 is held by clamp 402. Heating unit 403 generatesand transfers heat to the thermoplastic sheet 408. Heating unit 403contains a high wattage heating coil. Radiant heat 409 from heating unit403 is transferred to the thermoplastic by convection and radiation.FIG. 4C illustrates a softened state of the thermoplastic sheet readyfor thermoforming.

FIG. 4D illustrates an exemplary process for thermoforming preparation,according to one embodiment. Thermoplastic sheet 408 is moved overphysical mold 202 b. To avoid thermoplastic sheet 408 reverting back toa rigid state due to rapid cooling, thermoplastic sheet 408 is quicklyapplied with a downward air pressure 410 onto physical mold 202 b. Inanother embodiment, downward pressure 410 are supplied either by humanoperator or a machine-driven action.

FIG. 4E illustrates an exemplary process for thermoforming, according toone embodiment. Downward pressure 411 is applied to the non-contact sideof thermoplastic sheet 408 to conform thermoplastic sheet 408 to theexternal contour of physical mold 202 b. This thermoforming process mustbe performed quickly before thermoplastic sheet 408 reverts back to arigid state due to rapid cooling. Pressure 411 can be supplied either bya human applied force to localized areas repeatedly or a systematicmachine driven operation to hold thermoplastic sheet 408 down onto mold202 b. Pressure chamber 406 is filled with compressed air to apply auniformly distributed pressure 411 over the entire non-contact side ofthermoplastic sheet 408.

FIG. 5A illustrates a cross-section of a physical mold afterthermoforming application, according to one embodiment. Thermoplasticsheet 408 is applied over physical mold 202 b. Thermoplastic sheet 408has yet not sufficiently conformed to the contour of physical mold 202b. There are still negative spaces or voids between thermoplastic sheet408 and physical mold 202 b, especially in undercut or significantvertical features.

FIG. 5B illustrates the application of a uniform distributed pressureduring thermoforming application, according to one embodiment. Pressure411 is supplied by compressed air filling pressure chamber 406 abovethermoplastic sheet 408 and is applied over the non-contact side ofthermoplastic sheet 408.

FIG. 5C illustrates an exemplary cross-section of a physical mold duringthermoforming application after a uniform pressure has been applied.While still in a softened state, pressure 411 forces the sheet toconform to the shape of physical mold 202 b, including filling in spacesor voids between thermoplastic sheet 408 and physical mold 202 b.Compressed air remains in pressure chamber 406, applying a uniformdistributed pressure 411. This allows thermoplastic sheet 408 tomaintain the fully conformed shape, as it cools down and transitionsback to a rigid state. Once thermoplastic sheet 408 transitioned back tothe rigid state, the compressed air is evacuated from pressure chamber406, and the thermoformed mold is removed from the system.

FIG. 6A illustrates an exemplary thermoformed mold, according to oneembodiment. The thermoformed mold is removed from the system fortrimming. Mold 202 b and features 203-206 are fully enclosed within thethermoplastic sheet. Due to the undercuts and vertical features of mold202 b, thermoformed sheet 408 cannot be removed from mold 202 b beforetrimming.

FIG. 6B illustrates an exemplary process for trimming a thermoformedthermoplastic sheet, according to one embodiment. Excess thermoplasticsheet is trimmed off to separate from mold 202 b and obtain dentalimplant surgical guide 603. The trimmed portion of the thermoformedsheet forms the basis dental implant surgical guide 603. The shape ofthe trimmed thermoformed sheet is critical to the stability and fitquality of dental implant surgical guide 603 onto the patient, as wellas obstruction to the surgeon in the localized area around the surgicalsite. Surgeon's preference may be taken into account during the trimmingprocess. Based on these trimming parameters, the trimming path may bedetermined by an automatic software algorithm. The automatic algorithmof the trimming path may also be aided by an operator plotting a pilotpath first in the software. The numerical information of the trimmingpath are input to an automatic cutting tool such as a six-axis robot ora computer-numerical controlled (CNC) machine to trim off thermoplasticsheet 408 as specified.

There are various methods to remove the excess off thermoplastic sheet408. For example, thermoplastic sheet 408 is trimmed with a heat knife,cut with shears, or milled with a rotary tool. Milling with a rotarytool 602 can be accomplished either by human applied operation or asystematic machine driven operation. Forms of systematic machine drivenoperation include 4 or 5 axis computer numerical controlled millingsystem, which is programmed to follow a predetermined trim path. Thetrim path may be determined by a trained operator, using software, orcombination of both. In this case, a specialized clamping system is usedto lock the thermoformed mold into a reference position known to themilling system, so that the trim path is properly applied to mold 202 b.

Drilling bit 601 is carefully selected for the milling operation. Thedrill bit dimensions and type are critical to the edge quality of dentalimplant surgical guide 603. Certain drill bits allow for more efficientcutting, to separate the excess thermoplastic material from thethermoformed piece. Post process drill bits may be further used forrefining the edge, deburring, and smoothing to make the final product,dental implant surgical guide 603.

FIG. 7A illustrates an exemplary milling procedure, according to oneembodiment. The excess thermoplastic material is milled off aroundplatform-socket feature 203. FIG. 7B illustrates an exemplary trimmedthermoplastic piece with a socket receptacle flat planar surface,according to one embodiment.

The excess thermoplastic material above platform-socket feature 203 isremoved. The location of platform-socket feature 203 is carefullydetermined by the modeling software in virtual model 201 and thecorresponding mold 202 b with the desired position and trajectory.Rotary tool 602 is carefully used to remove the excessive thermoplasticmaterial down to a planar surface exposing cylindrical inner diameterhole 710. Once the milling operation is complete, any detachablecomponents, such as the part seated within the platform-socket, areremoved from mold 202 b. This allows for easier removal of thermoformedpiece 408 from mold 202 b.

FIG. 7C illustrates an exemplary process for inserting a metal tube intoa socket receptacle, according to one embodiment. Tube 701 with a fixedouter diameter 705 and inner diameter 704 is inserted into cylindricalinner diameter hole 710 of trimmed thermoformed piece 408. Tube 701 canbe made of various bio compatible materials such as plastic, ceramic, ormetal such as titanium, and stainless steel.

FIG. 7D illustrates a cross-section of a metal tube when inserted intothe socket receptacle, according to one embodiment. Tube 701 ispermanently attached to the trimmed thermoformed piece at interfaceboundary 702 between tube 701 and thermoformed piece 408. Variousadhesives can be used to attach the tube to thermoformed piece 408,including bio compatible adhesives, cements, or resins. Ideal adhesivesachieve a strong chemical bond between the thermoplastic material 408and tube 701. Bonding strength is vital to prevent failure or prematuredetachment of the surgical guide from the guide due to significantshearing force. The outer surface of tube 701 may be textured with roughtexture or features to promote adhesion. The flange lip of tube 701comes in contact with the planar surface of cylindrical inner-diameter704 of thermoformed piece 408, allowing tube 701 to be positioned at afixed height. In addition, tube 701 may be removably attached instead ofpermanently attached to facilitate switching if necessary.

Tube 701 allows for the facilitation of other mating instruments orsurgical drill bits to follow the constrained path of the determinedimplant trajectory. Since the offset position of the platform-socket 203from the planned implant position and the fixed height of tube 701 isknown, the depth from tube 701 to the planned implant position is alsoknown. Thus, the dental implant surgical guide provides clinicalinformation to the surgeon to achieve accurate control of position,trajectory, and depth for placing a dental implant.

FIG. 8 illustrates an exemplary finished dental implant surgical guide,according to one embodiment. After any post-process work and cleaning orsterilization, the manufacturing of the dental implant surgical guide801 is produced. The finished product includes trimmed thermoformedpiece 408, tubes 701 over each implant site, and if necessary tube 702for any anchoring devices (e.g., anchor pin 103) used to stabilize guide801 while drilling a hole.

A method and system for generating a dental implant surgical drill guideis disclosed. Although various embodiments have been described withrespect to specific examples and subsystems, it will be apparent tothose of ordinary skill in the art that the concepts disclosed hereinare not limited to these specific examples or subsystems but extends toother embodiments as well. Included within the scope of these conceptsare all of these other embodiments as specified in the claims thatfollow.

What is claimed is:
 1. A method comprising: receiving patient-specificimage data comprising a plurality of two-dimensional images; identifyinga set of two-dimensional anatomical landmarks from the plurality oftwo-dimensional images of the patient-specific image data; receiving apatient-specific virtual model; identifying a set of three-dimensionalanatomical landmarks from the patient-specific virtual model; aligningthe patient-specific image data and the patient-specific virtual modelin a three-dimensional space by matching the set of two-dimensionalanatomical landmarks rendered in the three-dimensional space and the setof three-dimensional anatomical landmarks.
 2. The method of claim 1,wherein the patient-specific image data comprises alignment dataassociated with a removable alignment unit, and wherein thepatient-specific virtual model is aligned with the patient-specificimage data using the alignment data.
 3. The method of claim 1, whereinthe patient-specific virtual model is obtained by a CT scan or anoptical surface scan of a patient's mouth or a patient-specific physicalmodel.
 4. The method of claim 1, wherein the set of two-dimensionalanatomical landmarks comprises a teeth or a gum.
 5. The method of claim1 further comprising: placing a virtual dental implant in thepatient-specific virtual model according to a virtual implant plan;generating a virtual mold based on the patient-specific virtual model;generating a physical mold from the virtual mold; generating athermoformed piece by covering the physical mold with a thermoplasticsheet via a thermoforming process; and generating a dental implantsurgical guide that comprises the thermoformed piece.
 6. The method ofclaim 5, wherein the virtual mold comprises a platform and a socket thatdenote a position and an orientation of the virtual dental implant. 7.The method of claim 6, wherein the position and the orientation of thevirtual dental implant are determined based on the virtual implant planand are transferred to the dental implant surgical guide.
 8. The methodof claim 5 further comprising modifying the virtual mold by eliminatingundercuts or a recessed space from the virtual model.
 9. The method ofclaim 5, wherein the physical mold is generated by a rapid prototypingprocess using the virtual mold, and wherein the rapid prototypingprocess is selected from a group comprising selective laser addition(SLA), 3D printing, and milling.
 10. The method of claim 5, wherein thevirtual model further comprises an anchor pin to stabilize the dentalimplant surgical guide while drilling a hole into a jawbone.
 11. Themethod of claim 5, wherein the thermoplastic sheet is thermoformed overthe physical mold to match an outer shape of the physical mold.
 12. Themethod of claim 5, further comprising trimming the thermoformed piece bycutting with shears, trimming with a heat knife, or milling using arotary tool or a computer numerical controlled rotary tool.
 13. Themethod of claim 5, wherein a shape of the dental implant surgical guideis determined by a trained operator, software, or a combination of theboth.
 14. The method of claim 5, wherein the thermoplastic sheet is madeof a bio-compatible, transparent material that provides rigidity tosupport a tube while drilling a hole into a jawbone.
 15. The method ofclaim 14, wherein the tube is made of plastic, ceramic, stainless steel,or titanium.
 16. The method of claim 14, wherein the tube is permanentlyor removably attached to the thermoformed piece.
 17. The method of claim14, wherein the tube is attached to the thermoformed piece usingbio-compatible adhesives, cements, or resins.
 18. The method of claim14, wherein the tube is have a surface texture or a feature to promoteadhesion to the thermoformed piece.
 19. A dental implant surgical guidecomprising: a thermoformed piece that is thermoformed over a physicalmold to conform to a shape of the physical mold, wherein the physicalmold is generated based on a patient-specific virtual model; and a tubeattached to the thermoformed piece at a site of a virtual dentalimplant, wherein the virtual dental implant is placed in thepatient-specific virtual model according to a virtual implant plan,wherein the patient-specific virtual model comprises: a set oftwo-dimensional anatomical landmarks from a plurality of two-dimensionalimages of a patient-specific image data; a set of three-dimensionalanatomical landmarks from a patient-specific virtual model, wherein thepatient-specific image data and the patient-specific virtual model arealigned in a three-dimensional space by matching the set oftwo-dimensional anatomical landmarks rendered in the three-dimensionalspace and the set of three-dimensional anatomical landmarks.
 20. Thedental implant surgical guide of claim 19, wherein the tube denotes aposition, and an orientation of the virtual dental implant